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Potentially inappropriate medications (PIMs) have been associated with poor outcomes in older adults. Electronic health record (EHR)-based interventions may be an effective way to reduce PIM prescribing. The main objective of this study was to evaluate changes in PIM prescribing to older adult veterans ≥65 years old in the ambulatory care setting preimplementation and postimplementation of medication alert messages at the point of computerized provider order entry (CPOE). Additional exploratory objectives included evaluating provider type and patient–provider relationship as a factor for change in PIM prescribing. A total of 1539 patients prealert and 1490 patients postalert were prescribed 1952 and 1897 PIMs, respectively. End points were reported as the proportion of new PIM orders of total new prescriptions. There was no significant difference in the rate of new PIMs prealert and postalert overall, 12.6% to 12.0% (P = .13). However, there was a significant reduction in the rate of the top 10 most common newly prescribed PIMs, 9.0% to 8.3% (P = .016), and resident providers prescribed fewer PIMs during both time periods. A simple, age-specific medication alert message during CPOE decreased the incidence of the most frequently prescribed PIMs in older adults receiving care in an ambulatory care setting. [ABSTRACT FROM AUTHOR]

Antiretroviral therapy has decreased HIV-related mortality. However, the incidence of diabetes as a co-morbidity is increasing as HIV-positive patients age. The purpose of this study was to assess the correlation between markers of HIV-infection and diabetes and to determine the proportion of patients achieving an haemoglobin A1c (HbA1c) goal <7% according to specific antiretroviral therapy regimens and adherence. In this retrospective study, HIV-positive veterans with diabetes from 2007 to 2012 were identified. Patients were required to be on the same antiretroviral therapy and diabetes regimen for ≥3 months. In 56 patients, it was identified that for each unit increase in log10 viral load, HbA1c increased 0.67 units (p = 0.0085). Only 38% of patients prescribed a protease inhibitor–based regimen vs. 56% of patients not on a protease inhibitor–based regimen achieved an HbA1c goal (p = 0.1864). Additionally, patients on an insulin-based regimen and patients that were less adherent were less likely to be at HbA1c goal (p = 0.018 and p = 0.0378, respectively). Patients with higher viral loads and patients that were less adherent to antiretroviral therapy were more likely to have a higher HbA1c demonstrating that poor adherence to antiretroviral therapy leads to poor control of both disease states. [ABSTRACT FROM AUTHOR]

The article focuses on study of relationship between phosphodiesterase type 5 (PDE5) inhibitor and sexually transmitted diseases (STDs) in veteran population. It highlights that PDE5 inhibitors promote the vasodilation mechanism in the treatment of erectile dysfunction. As per the study conducted in Veterans Affairs Medical Center (VAMC) it suggested that PDE5 inhibitors do not increase the risk of STDs in VAMC patient population.

Cadaveric dissections have demonstrated the precar ious nature of the axillary nerve with relationship to three common sports medicine shoulder procedures: the anteroinferior acromioplasty and rotator cuff repair incision, the inferior capsular shift procedure, and the posterior portal for shoulder arthroscopy. [ABSTRACT FROM PUBLISHER]

An adequate and effective environmental movement must focus on resolving problems in the relationship between man and his natural environment in a way that will end human exploitation. Once the environmentalist has set overall humanitarian goals, he should follow the strategies of successful political activists, such as choosing a poputlar issue, building grassroots support, timing, crisis precipitation, flexibility, and openness to legal aid or negotiation. In short, the "environmental professional" man must become the "political" man (or woman) in order to promote human welfare, argues the authora committed activist. [ABSTRACT FROM PUBLISHER]

Focuses on the evolution of teaching in the U.S. Religious education in public schools; Neutrality of teaching religion in schools; Concerns of Christians on teaching religion in schools.

The nation's automobile fleet is changing toward increasingly fuel-efficient automobiles. These changes will have a favorable impact on discretionary income and, further, will lead to substitution effects favoring driving for pleasure. Such developments are likely to lead to an increased demand for tourist facilities geared toward such travel. [ABSTRACT FROM PUBLISHER]

The author comments on the teaching of man's evolution theory proposed by Charles Darwin, a naturalist philosopher, in the U.S. public school. He emphasizes that an unsupported hypothesis should not be taught to public school children especially when it is contrary to the biblical teachings. He contends that teachers should not replace their teachings in favor of guesses because it directly affect the philosophy of life. He asserts that the Christians opposed the teaching of irreligion in the public schools.

The article questions concerning the extent of a pupil in high school in the U.S. should be allowed to choose his studies. It urges that the lines of progress indicated in the suggestions of the report of the Committee of Ten should be followed. It stresses that the limit of choice established must depend on the subjects of secondary education, the educational values of the several studies, the knowledge of these values, the existing conditions and the advantage to be secured.

The article discusses how faith influence the people to fight against defeats and despairs and the religion of democracy which is good order and justice with liberty.

The article presents a statement made by William Jennings Bryan which discusses about the wisdom of going to war. Bryan contends that such wisdom must be discussed before the U.S. enters a war. However, the discourse is closed when the Congress acts on it. He urged the Americans to stand together and fight for it. He suggested that they must be on he side of the nation though there are only two sides of the war.

The article comments on the methods of escaping from the trap of human habits toward freedom. The author inferred that the school carries the responsibility of prescribing tasks because these tasks can drive the children into the trap. The author suggests that the trap of habits can be eluded by actions which lie outside the routines involved and in cases of occupational trap, by sound mastery of the occupation itself.